The U.S. Government Accountability Office (GAO) has designated Medicare as a high-risk program, in part because of its outsize impact on the federal budget. As the largest single purchaser of health care in the U.S., Medicare often pays lower prices than other purchasers. However, laboratory tests historically received higher payment rates from Medicare than they did from private payers. Since the federal government was paying so much, Congress directed GAO to review the implementation of new Medicare payment rates for laboratory tests. These new rates are intended to bring them in line with the rates private payers receive.
In an opinion piece, the author misrepresented the findings of a recent GAO report on the implementation of these new payment rates for clinical laboratory tests. Julie Khani stated that we “proposed hypothetical scenarios to suggest labs are unbundling certain panel tests and receiving higher reimbursement.”
